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• May want to do selective validiation– During testing and debugging– During conformance testing– During the creation of each message– During the decoding of each message– Only on some fields– Only when errors occur– Or all of the above
• Message development TCs have stewardship– Ultimate authority for domain contents– Follow RIM harmonization rules
• Vocabulary Facilitators– Insure that good vocabulary practices are followed– Actual maintenance of domain specification database– Submit new concepts to vocabulary providers
• All vocabulary/terminology providers can provide mappings to HL7 domains
• The complete domain is a union of standard domain plus local concepts (as a union of the two)
• Rules– Local concept can not replace standard concept– Local code system names must start with “99” – Local codes should be submitted to HL7 for inclusion in
standard domain and forwarded to terminology developers
• This is only the first version. There will be future enhancements to domain specifications and to the table design
• Requirements: (UML model not shown)– Unique, non-sense identifier– Unique textual name– Description/definition– Edit note– Version tracking– Can be specific to a realm of use– Each “leaf” set is from a single vocabulary– Domains can be recursively defined– Set notation will be used to describe relationships
1 Gender Root HL7 The gender of a person. "Gender:Root:HL7" A 110001 MyGender Root HL7 The gender of a person.
Does not allow Unknownor Other.
("Gender:Root:HL7" - "O:HL7-0001")
A 1
60001 ClinicalDiagnosis USA SNM3 A clinical diagnosis orsyndrome.
ChildrenOf("D*") A 3
60002 ClinicalDiagnosis USA MED Diagnosis or syndromethat best explains thepatient's symptoms.
SubTypes("1278") A 3
70001 BillingDiagnosis USA IC9 The billing diagnosis forthird partyreimbursement purposes.
Any("ICD-9CM") A 2
5 Race Root HL7 The race of a person. "Race:Root:HL7" A 150005 Race USA HL7 The race of a person. "Race:USA:HL7" A 250006 Race UK RC A person's race. ChildrenOf("Race") P 120001 AmericanIndian
20002 Asian USA HL7 Asian Race "Asian:USA:HL7" A 120003 BlackOrAfrican
AmericanUSA HL7 Black or African
American Race"BlackOrAfricanAmerican:USA:HL7"
A 1
20004 NativeHawaiianOrPacificIslander
USA HL7 Native Hawaiian orPacific Islande Racer
"NativeHawaiianOrPacificIslande:USA:HL7"
A 1
20005 WhiteRace USA HL7 White Race "WhiteRace:USA:HL7" A 130001 AmericanIndian USA HL7 American Indian Race "AmericanIndian:USA:HL7" A 130002 AlaskaNative USA HL7 Alaska Native Race "Alaska Native:USA:HL7" A 1
• A value set gets a Vin number when it first becomes a part of the table
• A value set gets a Vout number when it becomes inactive
• A value set with a blank Vout is currently active
HL7 ValueSet ID
DomainName
Realm CodeSystem
CurrentStatus
Vin Vout
1 Gender Root HL7 A 110001 MyGender Root HL7 A 160001 ClinicalDiagnosis USA SNM3 A 360002 ClinicalDiagnosis USA MED A 370001 BillingDiagnosis USA IC9 A 2
• HL7 Concept ID could be replaced by universal concept identifier (UMLS CUI?)
• Supports multiple languages
HL7 ValueSet Id
HL7Concept
ID
CodeSys
SourceDomainName
TableID
CodeSysVin
Code Lang Description
1 40001 CR Sex 0220 6 1 E Male1 40002 CR Sex 0220 6 2 E Female1 40003 CR Sex 0220 6 3 E Other (Hermaphrodite)1 40004 CR Sex 0220 6 4 E Transsexual1 40005 CR Sex 0220 6 9 E Not Stated/Unknown1 40001 HL7 Gender 0001 2.3.1 M E Male1 40002 HL7 Gender 0001 2.3.1 F E Female1 40003 HL7 Gender 0001 2.3.1 O E Other1 40005 HL7 Gender 0001 2.3.1 U E Unknown
• Look in Value Set Definition Table– Use domain name, realm, and code system– Find and remember the Expression
• Pass the Expression to a terminology server (TQS)
• Knowledge of how to resolve HL7 Value Sets to individual elements is available in the Value Set Relationship Table and the Source Vocabulary Representation Table
• Knowledge of how to resolve external Value Sets is the responsibility of the terminology provider